Research Gaps - Adult Sinusitis

The guideline development group identified knowledge gaps based on existing practice patterns and the scope and quality of supporting literature. We present these gaps below to highlight areas for future research and investigation.

Define the natural history and management of subacute rhinosinusitis.

Determine the validity of diagnosing ABRS by patient history without confirmatory physical examination.

Refine and validate diagnostic criteria for VRS and ABRS.

Determine whether a 7- or 10-day symptom duration is more likely to be associated with ABRS.

Assess the validity of diagnosing ABRS before 10 days based on persistent fever plus concurrent purulent nasal discharge.

Standardize the definition of “severe” illness in patients diagnosed with ABRS and determine whether it is a valid and useful distinction for diagnosis in adults. Establish the proper terminology and management of sinusitis symptoms lasting between 4 and 12 weeks.

Conduct RCTs with a superiority design that emphasize time to improvement/resolution, not just binary outcomes at fixed time points.